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预测儿童哮喘患者正确使用吸入器技术和哮喘控制的因素。

Predictors of proper inhaler technique and asthma control in pediatric patients with asthma.

机构信息

Department of Clinical Pharmacy, Faculty of Pharmacy, Jordan University of Science and Technology, Irbid, Jordan.

Department of Pediatrics and Neonatology, Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan.

出版信息

Pediatr Pulmonol. 2021 May;56(5):866-874. doi: 10.1002/ppul.25263. Epub 2021 Jan 26.

Abstract

BACKGROUND

Improper use of asthma inhalers is one of the potential factors of poor asthma control among children. This study aimed to assess the proper handling of asthma inhalers and asthma control in addition to factors influencing them among pediatric patients who self-administer their inhalers.

METHODS

A cross-sectional study was conducted in Jordan from February 2019 to February 2020. All eligible pediatric patients with asthma attending outpatient settings were approached. The inhalation technique was assessed according to a standard checklist, and asthma control was assessed using the Asthma Control Test.

RESULTS

A total of 150 patients were included in this study. A metered dose inhaler (MDI) was the most commonly used inhaler device (89.4%) which was used appropriately by only 13.4% of participants. Whereas, appropriate use of Turbohaler and Diskus was reported by 38.5% and 28.9%, respectively. The higher level of parental knowledge was associated with higher number of correct MDI steps (OR = 1.066; 95% CI = 1.010-1.125; p = .020) and less reported errors in critical steps (OR = 0.949; 95% CI = 0.900-0.999; p = .047). Higher level of both parental education and pediatric average stigma score (less stigmatized) were associated with better asthma control ([OR = 5.181; 95% CI = 1.238-21.677; p = .024], [OR = 2.825; 95% CI = 1.420-5.619; p = .003], respectively).

CONCLUSION

Continuous education on appropriate inhaler self-administration for asthmatic children is highly recommended. Clinical pharmacists play a major role toward improving the administration of inhalers through patient training and counseling.

摘要

背景

哮喘吸入器使用不当是儿童哮喘控制不佳的潜在因素之一。本研究旨在评估自行使用吸入器的儿科患者正确使用吸入器和哮喘控制情况,以及影响这些情况的因素。

方法

本研究于 2019 年 2 月至 2020 年 2 月在约旦进行了一项横断面研究。所有符合条件的在门诊就诊的哮喘儿科患者均接受了调查。根据标准检查表评估吸入技术,使用哮喘控制测试评估哮喘控制情况。

结果

本研究共纳入 150 例患者。其中最常用的吸入器装置是计量吸入器(MDI)(89.4%),只有 13.4%的参与者正确使用。而适当使用都保和准纳器的比例分别为 38.5%和 28.9%。父母知识水平较高与正确的 MDI 步骤数量较多相关(OR=1.066;95%CI=1.010-1.125;p=0.020),且关键步骤报告的错误较少(OR=0.949;95%CI=0.900-0.999;p=0.047)。父母教育程度和儿科平均污名评分(污名程度较低)较高均与更好的哮喘控制相关([OR=5.181;95%CI=1.238-21.677;p=0.024],[OR=2.825;95%CI=1.420-5.619;p=0.003])。

结论

强烈建议对哮喘儿童进行适当的吸入器自我管理进行持续教育。临床药师通过患者培训和咨询,在改善吸入器管理方面发挥着重要作用。

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